Trans-Abdominoplasty Silicone Breast Augmentation

(TASBA)

Filiberto Rodriguez, MD, FACS, FAACSRGV Cosmetic Surgery & Vein Care

McAllen, TX

No Financial Disclosures

Introduction

• Breast augmentation remains hugely popular

• Trans-Umbilical Breast Augmentation (TUBA) allows minimally invasive placement of saline implants with no scars on the breast

TUBA

TUBA

• Patient Selection– Minimal breast ptosis– Minimal assymetry

that can be corrected with different sized implants or fill volumes

– Ideally IMF not too tight

• Know how to do

TUBA

TUBA - Cons

• Can only place Saline implants– Pt dissatisfaction with

feel of saline implants?

• Increased demand for silicone gel implants– Trans-axillary to avoid

breast scars in select patients

Trans-Abdominoplasty

• Placement of silicone implants via abdominoplasty has been described

• Not widely practiced due to the limited exposure from the costal margin and the challenging dissection

Keller Funnel 2

• Greatly facilitates placement of silicone gel implants through smaller IM, PA, & Trans-Ax incisions

• Theoretical advantage for decreased capsular contracture

TASBA

1. TUBA pre-dissection2. Abdominoplasty3. Keller Funnel4. Facilitated Trans-

Abdominoplasty Silicone Breast Augmentation (TASBA)

1. TUBA

• Patient selection as per TUBA

• Use classic TUBA techniques to dissect subpectoral pocket and place saline sizers

2. Elevate Abdominoplasty Flap

• Costal margin ~ 5-6cm from IMF

• Dilate TUBA tracks 2 finger breadths (similar to Trans-Axillary)

• Allows use of blunt finger dissection to optimize pocket (better than TUBA alone)

3. Keller Funnel 2

• Saline sizers are removed

• Keller Funnel 2 facilitates placement of silicone gel implants into pre-dissected supbectoral pocket

TASBA Before & After at 6 weeks

TASBA Before & After at 8 weeks

Settling of the Implants

2 weeks post-op 8 weeks post-op

Pearls

• Wylie Renal Vein Retractor is very helpful for exposure for placement of the Keller Funnel and implant delivery

• Consider beginning Singulair (Montelukast) 2 weeks prior and continuing 3-4 months post-op to prevent capsular contracture in this patient population seeking to avoid scars on their breasts

Summary

• In properly selected patients, the TASBA procedure provides a wonderful alternative for combined breast augmentation and abdominoplasty (commonly referred to as a Mommy Makeover) that avoids any breast scars

• The combination of TUBA techniques with the Keller Funnel greatly facilitates the placement of silicone gel implants though a trans-abdominoplasty approach

Thank you

South Padre Island, TX